PO 14 RE IMMUNIZATION SVC WITH ADHS.PDF

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ARIZONA STATE CONTRACT
CONTRACT RELEASE
ProcureAZ Purchase Order No.: ADHS13-041805:14
Organizational Reference No.: P00000031559
Issued: 09/24/2015
Vendor Number: 000010983 Arizona Department of Health Services
Maricopa County Public Health Epidemiology and Disease Control Immunization
4041 N. Central Avenue, #1400 Program
Phoenix, AZ 85012 150 N. 18th Avenue, Suite 120
Phoenix, AZ 85007
US
Email: procure@azdhs.gov
Contract No,: ADHS13-041805 (602) 364-3630
Title: Maricopa County Seasonal Pan Flu Immunization Services MAIL INVOICE IN DUPLICATE TO:
Arizona Department of Health Services
Epidemiology and Disease Control Immunization
Program
150 N. 18th Avenue, Suite 120
Phoenix, AZ 85007
US
Email: procure©azdhs.gov
(602) 364-3630
Release Instructions
TERMS AND CONDITIONS set forth in our Bid, Quotation, or Purchase Order
are incorporated herein by reference and become a part of this order.
,
Account Code: 2015—FEDEDC2540-5171—HS2000—HS20000-6811--PHS-EDC- Payment Terms: Net 30
IMMUVFC-1215------HSA
Shipping Terms:
Delivery Calendar Day(s) A.R.O.: 0
Item Description I Requisition Quantity Unit Unit Price , Total
Class-Item 948-92
"I Immunization Program - PO for the delivery of Seasonal Pan Flu 1,00 TOTAL $ 140,875.00 $ 140,875.00
Immunization Services & Activities necessary to aid the MARICOPA
COUNTY Health Dept. PO period thru 12/31/2015. Contract# ADHS13-
041805 Contract period thru 12/31/2017, CFDA$ 93-268
TOTAL: $ 140,875.00
Approved By: Myra Chavez
Phone No.: (602) 364-3649

C-86-13-074-3-07 ATTACHED TO AND A PART OF
Purchase Order ADHS13-041805-14
Contract No. ADHS13-041806
Maricopa County – Immunization Services
IN WITNESS WHEREOF, the parties agree to enter into this Contract:
FOR AND ON BEHALF OF
MARICOPA COUNTY
By
Chairman, Board of Supervisors
Date
ATTEST:
Clerk of the Board
Date
APPROVED AS TO FORM:
Attorney for Maricopa County
Date